Abstract

Over 3 billion people use solid fuels as a means of energy and heating source, and ˜ 50% of households burn them in inefficient, poorly ventilated stoves. In 2010, ˜ 43% of the 640 million preschool children in 220 countries suffered from a certain degree of anemia, with iron deficiency as the main cause in developed countries whereas its causes remained multifactorial in the undeveloped group. In this study, we explore the relations of country-wide variables that might affect the people's health status (from socioeconomic status to more specific variables such as water access). We found independent relationship between solid fuel use and anemia in children under five years old (p < 0.0001), taking into account the prevalence of anemia in pregnant woman and the access to improved water sources. Countries in which the population uses solid fuel the most have over three times higher anemia rates in children than countries with the lowest prevalence of solid fuels use. There is still a complex relationship between solid fuels use and anemia, as reflected in its worldwide significance (p < 0.05) controlled for measles immunization, tobacco consumption, anemia in pregnant mothers, girl's primary education, life expectancy and improved water access but not (p > 0.05) when weighing for sanitation access or income per capita.Highlights3 billion people in the world use solid fuels.Globally 47.4% of children under five years old had anemia.There is an association between solid fuel uses and anemia in children.Liver hepcidin for macrophages IL-6 production links to indoor particulates could explain anemia.